Name of the Procedure:

Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, including reverse transcription when performed. Common name(s): HIV-1 Viral Load Test, HIV-1 PCR Test

Summary

This procedure detects the presence and quantity of HIV-1 in a patient’s blood by amplifying the virus's genetic material (DNA or RNA). It uses a sensitive technique to identify even small amounts of the virus, providing crucial information for diagnosis and treatment.

Purpose

The primary purpose of this test is to diagnose HIV-1 infection and monitor viral loads in patients known to have HIV-1. It helps guide treatment decisions and evaluate the effectiveness of antiretroviral therapy. The goal is to manage and reduce the patient's viral load to undetectable levels.

Indications

• Symptoms of HIV infection (e.g., flu-like symptoms, extended fever, weight loss)
• High-risk behaviors for HIV (e.g., unprotected sex, needle sharing)
• Confirmation of a positive HIV screening test
• Monitoring the effectiveness of HIV treatment

Preparation

• No fasting required.
• Patients should inform their healthcare provider about any medications they are taking.
• A blood sample will be needed, so wearing a short-sleeve shirt can be helpful.

Procedure Description

1. A blood sample is drawn, typically from a vein in the arm.
2. The sample is sent to a lab where the viral RNA is extracted.
3. Reverse transcription is performed to convert RNA into complementary DNA (cDNA).
4. The cDNA is then amplified using polymerase chain reaction (PCR) techniques.
5. The amplified DNA is detected using specific probes that bind to HIV-1 genetic sequences.
6. The amount of viral DNA detected is quantified to determine the viral load.

Duration

The blood draw takes about 10 minutes, but lab processing and results can take several days to a week.

Setting

This procedure is performed in an outpatient setting, such as a hospital lab, clinic, or specialized testing laboratory.

Personnel

• Phlebotomist or nurse for blood draw
• Laboratory technicians or technologists for sample processing
• A physician or specialist to interpret the results

Risks and Complications

• Minor discomfort or bruising at the blood draw site
• Rarely, infection or excessive bleeding may occur
• No direct complications related to the lab processing itself

Benefits

• Accurate detection of HIV-1 infection
• Helps in timely initiation and adjustment of treatment
• Monitoring viral load can gauge treatment effectiveness
• Early detection improves prognosis and reduces the risk of transmission

Recovery

• Minimal recovery time; patients can usually resume normal activities immediately after the blood draw.
• Follow-up with your healthcare provider for results and further instructions.

Alternatives

• HIV antibody tests (less sensitive in early infection stages)
• HIV antigen/antibody combination tests (also effective but less sensitive for very low viral loads)
• Pros of alternatives: often quicker results, less costly
• Cons of alternatives: less sensitive, especially in early infection or low viral load scenarios

Patient Experience

Patients may experience a brief sting or pinch during the blood draw. Some minor soreness or bruising at the puncture site might occur afterward. The procedure itself is straightforward and quick, leading to actionable results that can significantly impact treatment and quality of life. Pain relief or comfort measures are generally unnecessary due to the simplicity and minimally invasive nature of the blood draw.